Beyond registration: The ongoing

language support needs of foreign-

trained healthcare professionals.

2

• Reliance on foreign-trained healthcare professionals

varies across English-speaking countries.

• For example, according to OECD 2015 statistics the

percentage of foreign-trained doctors ranges from

around a quarter in Canada and the USA, to a third

in the UK and Australia and almost half in New

Zealand.

• Regardless of the degree of reliance, it’s vital to

ensure the required English proficiency to protect

patient safety and quality of care.

Setting the scene: English testing

Source: http://stats.oecd.org/Index.aspx?DataSetCode=HEALTH_WFMI

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• Foreign-trained healthcare professionals seeking

employment in English-speaking environments need

to prove English proficiency to gain registration.

• Requirements set by healthcare regulators are

different for each profession in each country and

include English tests, among other forms of proof.

• English tests include: OET, IELTS, TOEFL, PTE and

CELBAN (used for nurses in Canada).

Proving English proficiency for healthcare

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Language tests currently used: by country

Canada

Nurses: CELBAN

Doctors: IELTS/TOEFL

Immigration: IELTS/CELPIP

USA

Healthcare: IELTS/TOEFL

Immigration: IELTS

UK & Ireland

Doctors & Nurses: OET/IELTS

Other healthcare: IELTS

Immigration: IELTS/Trinity

Australia

Healthcare: OET/IELTS/TOEFL/PTE

Immigration: OET/IELTS/TOEFL/PTE/CAE

New Zealand

Healthcare: OET/IELTS/TOEFL/PTE

Immigration: OET/IELTS/TOEFL/PTE/FCE

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• OET assesses the English language skills of

healthcare professionals seeking to register and

practise in an English speaking environment.

• OET replicates English language communication

skills required for effective communication in a

healthcare environment.

• It provides a valid and fair assessment of all four

language skills: speaking, listening, reading and

writing.

Overview of OET

OET candidates: top 10 nationalities

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Indian Filipino Australian Nepalese Chinese SouthKorean

Egyptian Iranian HongKongese

Sri Lankan

2017-18 2016-17

Comparing data from 2016-17 and 2017-18• Sharp increase in number of candidates from India

• Significant increase in number of candidates from Philippines

• Overall increase from all nationalities.

Why candidates choose OETRecognition

Accepted by healthcare boards and councils in the UK,

Ireland, Australia, New Zealand, Singapore and Dubai,

as well as leading healthcare educators. OET is also

recognised by Australian and New Zealand immigration

for visa purposes.

Relevance and familiarity

OET is recommended by past test takers because

test materials reflect healthcare scenarios leading

to confidence on test day.

Confidence

OET helps candidates develop the language skills to

communicate effectively in the healthcare workplace.

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How OET is different to other tests

Example 1:

Writing

General/AcademicEnglish Test

Write an essay on a general topic

OET

Write a healthcare letter, usually a referral

letter, based on case notes

Example 2:

Speaking

General/Academic English Test

Structured interview on a general topic

OET

Health professional patient role-plays

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9

How OET compares with IELTS

Registration of foreign-trained doctors

IELTS - Academic OET

Australia 7 in each sub-test B in each sub-test

New Zealand 7 in each sub-test B in each sub-test

UK 7 in each sub-test, with

overall in 7.5

B in each sub-test

Ireland 7 in each sub-test B in each sub-test

Canada 7 in each sub-test n/a

The survey

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OET assesses English language and communication

skills to ensure patient safety and quality of care.

Our question: What are the ongoing

language training needs of foreign-

trained healthcare professionals?

Improving communication skills

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Survey methodology and objectives

Methodology

An online survey with 14 questions was distributed to

55,000 OET alumni via email in February 2018. There

were 2,083 (4%) responses in a 28-day period.

Objectives

The purpose of the study was to survey OET alumni on

their English test experience and assess the need for

advice on how to improve English language and

communication skills after registration.

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1. Is a healthcare-specific English test useful for

preparing candidates for the workplace?

2. How likely are OET alumni to access ongoing

advice on English language communication skills?

Survey questions

Survey findings

Top 5 professions by candidature and %

of survey respondents in each profession

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84.4% 10.4% 1.7% 1.4% 0.8%

Nursing Medicine Pharmacy Physiotherapy Dentistry

2083 survey respondents show similar

proportions as OET candidature:

80.8% Nurses

10.9% Doctors

2.74% Dentists

1.92% Physiotherapists

1.68% Pharmacists

1.96% Other professions

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OET language skill assessment criteria

Reading

Show you can read and

understand different types

of text on health-related

subjects.

Writing

Show you can write a letter

in a clear and accurate way

which is relevant to the

reader.

Speaking

Show you can effectively

communicate in a real-life

context through the use of

healthcare role plays.

Listening

Show you can follow and

understand a range of health-

related spoken materials,

such as patient consultations

and lectures.

Skills perceived as important by healthcare

professionalsOET involves clinically relevant communication tasks, and interdisciplinary

research has ensured performance is judged against clinically relevant

criteria.

• ARC Linkage project (2013, Elder etc.) The Towards Improved Healthcare

Communication, and ARC Linkage project (2017, Knock etc) Towards

Improved Quality of Written Patient Records investigated domain experts'

views on what they value in communications in health care contexts:

Linguistic skills and clinical communication skills

• These studies result in clinical communication criteria that will be assessed

alongside the linguistically-oriented criteria in OET.

• The introduction of the clinical criteria will certainly influence how the

candidates prepare or are prepared for the test, thus creating an immediate

positive washback.

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OET helped develop language skills

needed in my workplace

Agree or strongly agree:

61% of doctors currently working in English-

speaking countries

71% of nurses currently working in English-

speaking countries

63% of other professions

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Qualitative findings – countries where

English is a secondary language

“It’s quite relevant I would say. It has helped me fine tune

my letter writing, especially referral letters and also

communication skills.”

Doctor from Malaysia currently working in Malaysia.

“I’m working as a nurse in Spain and I have a lot of

patients from the UK. Thanks to OET I’m able to talk to

them about diagnosis, treatment, tests etc. without any

problems.”

Spanish nurse currently working in Spain.

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Qualitative findings – challenges faced

by new recruits in the workplace

“I rarely have difficulty to communicate with

customers but occasionally get stuck when customers

start talking with slang or in very casual ways.”

Pharmacist currently working in Australia.

“I’m trained in American English. Where I work, Kiwis

speak a different English and sometimes their accent

needs quite getting used to.”

Nurse from the Philippines currently working in Auckland.

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How likely are you to access ongoing

advice and support from OET?

81% of all respondents are likely or very likely to

access ongoing advice and support from OET.

“All practicing healthcare professionals need mentorship

and training in communication and a safe environment to

develop new skills.”

Professor Peter Martin, Chair Clinical Communication at Deakin University.

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Qualitative findings – nurses trained and

qualified in an English-speaking country

“After studying nursing in Australia (in English) I was

shocked that I could not register and practice unless

an academic IELTS or OET test was taken.”

Nurse currently working in Perth, Australia unlikely to access ongoing advice.

What about the 19% who do not want to access ongoing

advice?

Qualitative results show that foreign nurses who have

trained in an English-speaking country are less likely to

access ongoing advice.

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Policy implication

Healthcare employers should consider providing

communication training with modules tailored for

internationally-trained staff

In the words of one of our candidates:

“Preparation for OET is useful…However, in the real

settings we need more effort to achieve this (good

communication). So continued support from OET will be

beneficial.”

Doctor from Japan currently working in Australia.

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Does limited communication impact

health in vulnerable communities?

Limited language proficiency is an obstacle to effective

communication affecting quality of care.

(Elder 2013). Source: Elder, C. et al. (2013) Towards improved healthcare communication: Development

and validation of language proficiency standards for non-native English speaking health professionals. ARC Linkage

Project.

In regional, rural and remote areas of Australia, international

medical graduates comprise 43% of the GP workforce. Source:

Medicare Australia

“Sometimes [language] is a challenge. Especially

when older people use some specific expressions or slang

and then younger people use a different slang.”Dr Pour Ali - http://www.abc.net.au/news/2016-03-21/migrant-doctor-finds-work-in-the-bush/7259312

Thank you